Using key informant interviews and focus group discussions in Armenia, this study sought to identify the desirability and feasibility of scaling-up community health insurance. The results suggest that there is broad-based political support for scaling up the schemes and this process is synergistic with major health sector reform directions. High levels of social capital within the rural communities should facilitate scaling up. Existing schemes have increased access and quality of care, but expansion of coverage is constrained by affordability and poor infrastructure and linkages with the broader health system. Long-term subsidies and system-building are essential if the expanded schemes are to be financially viable and pro-poor. Overall, successful scaling up community financing in Armenia would depend on addressing a range of obstacles related to legislation, institutional capacity, human resources and resistance to change among certain stakeholders.
Poletti, T.; Balabanova, D.; Kocharyan, H.; Arakelyan, K.; Hakobyan, M.; Normand, C. The desirability and feasibility of scaling up community health insurance in low-income settings - lessons from Armenia. Social Science and Medicine (2007) 64 (4) 509-520. [DOI: 10.1016/j.socscimed.2006.10.028]